Attachment 2_External Force Disruptors.docx

Attachment 2 to REQ-DASOBO-00066756 (formerly SP-1142-19), Amendment No. 1 External Force Disruptors

The ability to complete market analysis and implement the contract process prior to the end of the contract period was not totally completed in the timeframe projected in the original Special Procurement No. SP-1142-19 dated 7/10/2019 due to the following unavoidable issues which has negatively impacted the progress and more fully explained impacts with timeline described in Attachment 3 – Procurement Progress List:

1. Critical Staffing Shortages March 2020 – June 2022 +

a. The OSH Emergency Operations Center was activated from March 2020 through late 2022 to manage hospital pandemic response, including critically low staffing levels resulting from pandemic related absences.

b. OSH deployed non-nursing staff and managers from throughout the hospital to work on the units, offering overtime pay and differentials for critical staffing needs, accelerating the hiring process, hiring temporary workers, and signing additional contracts for agency staff.

c. 47 Oregon Guard members were assigned to OSH to support critically low hospital staffing levels from August 16, 2021, through June 30, 2022.

2. Nationwide Healthcare Worker Shortage is ongoing and expected to last for years.

a. Current vacancy rate for licensed nursing positions continues to remain high and is 25% with 108 vacant positions out of 435 budgeted positions.

3. Health Resources and Service Administration (HRSA) under the U.S. Department of Health and Human Services (HHS) estimates the nursing shortage will continue to climb until 2027 before beginning to ease over subsequent years. Staffing levels that will meet demand are expected to occur by 2035.Hospital-wide Plan of Correction May 2022 – December 2022

a. The Centers for Medicare and Medicaid Services (CMS) conducted survey in December 2021.

b. Results of the survey in May 2022 that pointed out several deficiencies related to patient safety and patient care that must be addressed by OSH to keep Medicaid certification.

c. OSH developed and implemented a hospital-wide Plan of Correction that included extensive policy updates and re-training for all 2,300 OSH employees and contracted staff. Policy planning and updates were performed by several collaborative OSH work teams led by OSH managers and executives. This effort and time required for re-training staff put further constraint on availability to secure resources with time to focus on the re-procurement efforts for the API Scheduling and time-tracking system.

d. Overtime was authorized for all-staff to complete required re-training due to critically low staffing levels.

4. Occupational Safety and Health Administration (OSHA) Audit September 2022 – January 2023

a. Remediation efforts for workplace violence citations. Efforts for remediation took already constrained resources to dedicate their time to resolve and further leaving no resources to work on re-procurement efforts outline in this Amendment to SP.

5. Oregon WorkDay Payroll Implementation January 2021 – February 2023

a. OSH engaged with WorkDay Payroll transition project and received confirmation that Oregon DAS WorkDay payroll module will not meet the business requirements of a 24/7 healthcare environment with current or planned future releases.

b. DAS approved a time feed from OSH scheduling and time system into WorkDay.

c. OSH assigned non-nursing resources for development of WorkDay time integration in March 2021 and completes project in February 2023.